Diagnosis of extra-intestinal microsporidiosis involving the lung, skin, and other organs, particularly in immunocompromised hosts
Diagnosis of ocular microsporidiosis
See Parasitic Investigation of Stool Specimens Algorithm in Special Instructions.
Trichrome-Blue Stain (Ryan Modification)
Encephalitozoon
Entercytozoon
Nosema
Pleistophora
See Parasitic Investigation of Stool Specimens Algorithm in Special Instructions.
Varies
This test is intended to be ordered on specimens other than stool and urine.
Question ID | Description | Answers |
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Q00M0042 | Specimen Source |
Submit only 1 of the following specimens:
Specimen Type: Duodenal aspirate (small intestinal aspirate, jejunal aspirate, small bowel aspirate)
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Additional Information: Ecofix and 10% formalin are acceptable preservatives.
Specimen Stability Information: Preserved Ambient (preferred) <10 days/Refrigerated <3 days/Frozen
Specimen Type: Respiratory secretions (bronchoalveolar lavage [BAL], sputum, bronchial wash, pleural fluid)
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Specimen Stability Information: Refrigerated <3 days (preferred)/Frozen <10 days
Specimen Type: Eye (vitreous fluid, corneal scraping, ocular fluid)
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Specimen Stability: Refrigerated <3 days
Specimen Type: Fresh tissue (lung, eye, bladder, rectal, intestinal, colon, skin, muscle, kidney)
Container/Tube: Sterile container
Specimen Volume: 3-mm biopsy in 0.1-mL sterile saline
Specimen Stability: Refrigerated <3 days
Specimen Type: Gallbladder aspirate/Bile aspirate
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Specimen Stability: Refrigerated <3 days/Frozen <10 days
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
See Specimen Required
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Specimen Type | Temperature | Time | Special Container |
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Varies | Varies |
Diagnosis of extra-intestinal microsporidiosis involving the lung, skin, and other organs, particularly in immunocompromised hosts
Diagnosis of ocular microsporidiosis
See Parasitic Investigation of Stool Specimens Algorithm in Special Instructions.
Microsporidia are highly specialized fungi that cause a wide variety of clinical syndromes in humans. The most common microsporidia are Enterocytozoon bieneusi and Encephalitozoon intestinalis, which infect the gastrointestinal tract and cause a diarrheal illness, and Encephalitozoon cuniculi and Encephalitozoon hellem, which can infect the conjunctiva, respiratory tract, and genitourinary system. Human infections have been reported most frequently in patients with AIDS, but also can occur in other immunocompromised patients, including solid organ allograft recipients and, sporadically, immunocompetent hosts. Less commonly, other microsporidia such as Vittaforma corneae and Brachiola species can cause disseminated or organ-specific disease. Diagnosis of microsporidiosis is traditionally performed by light microscopic examination of stool, urine, and other specimens using a strong trichrome (chromotrope 2R) stain for detection of the characteristic spores. Unfortunately microscopic identification can be challenging due to the small size of the spores (1-4 micrometer) and their resemblance to yeast. Molecular detection using species-specific PCR offers improved sensitivity and specificity and is available for the microsporidia that cause the majority of intestinal and renal infections (ie, Encephalitozoon species and Enterocytozoon bieneusi). The microsporidia stain is reserved for use with other (nonstool and nonurine) specimen sources due to the variety of other species that may be detected outside of the intestinal tract and kidney.
The antihelmintic drug, albendazole has been found effective in some infections due to Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis.
Negative
If positive, reported as Microsporidia detected
A positive result suggests an active or recent infection. Results should be correlated with the patient's clinical presentation and immune status.
A negative result indicates absence of detectable microsporidial spores in the specimen but does not always rule out ongoing microsporidiosis since the organism may be present at very low levels or shed sporadically.
These organisms are very difficult to identify among the multitude of organisms and artifactual debris present in feces.
1. Weber R, Bryan RT, Schwartz DA, Owen RL: Human microsporidial infections. Clin Microbiol Rev. 1994;7:426-461
2. Goodgame RW: Understanding intestinal spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora. Ann Intern Med. 1996;124:429-441
3. Wanke CA, DeGirolami P, Federman M: Enterocytozoon bieneusi infection and diarrheal disease in patients who were not infected with human immunodeficiency virus: case report and review. Clin Infect Dis. 1996;23:816-818
Specimen concentrates are stained by the trichrome-blue method.(DeGirolami PC, Ezratty CR, Desai G, et al: Diagnosis of intestinal microsporidiosis by examination of stool and duodenal aspirate with Weber's modified trichrome and Uvitex 2B stains. J Clin Microbiol. 1995;33:805-810)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
87015-Concentration
87207-Stain
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
MTBS | Microsporidia Stain | 10857-1 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
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MTBS | Microsporidia Stain | 10857-1 |